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New Mexico rates for HCPCS L3905

Wrist-hand orthosis (WHO), includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $537.03 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $588.84 / $912.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $870.96 / $1,047.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $602.56 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $1,584.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,096.48 / $1,621.81
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $741.31 / $1,148.15
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $1,288.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $537.03 / $1,318.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $489.78 / $724.44